Background: The
Netherlands implemented smokefree legislation in July 2008. However, this
legislation was reversed and reimplemented for small bars without employees
several times. Since October 2014, the smokefree legislation applies to all
bars again, but not all of them comply and designated smoking rooms are still
allowed.

Methods: A
nationally representative sample of adult smokers from the Netherlands was
interviewed each year between 2008 and 2016 as part of the International
Tobacco Control (ITC) Survey (n=1246-1773 per year). Trends in perceptions of rules
about smoking in bars they visited, seeing people smoke in bars during the last visit, support for smokefree
bars, and social acceptance of smoking in bars were examined with GEE analyses.

Results: There
was a significant increase in smokers reporting that bars they visited had a
total smoking ban (9% in 2008 to 45% in 2016), which was more often reported by
older and high income smokers. Between 10 and 18% of smokers reported that they
did not know the rules about smoking in bars; this was more often reported by
older smokers. Reports of having seen people smoking in bars during the last
visit decreased from 93% to 19%. Support for smokefree bars doubled (20% to
43%) and was higher among older and high educated smokers. Social acceptance of
smoking in bars decreased (75% to 41%) and was higher among younger and low
income smokers.

Conclusions: Eight
years after the implementation of smokefree legislation in bars, smoking in
bars has decreased but is far from eliminated in the Netherlands. Educational
campaigns targeted at younger and lower socioeconomic status smokers are needed
to inform these groups about the (need for) rules about smoking in bars. Now
that only a minority of smokers think it is still acceptable to smoke in bars, the
Dutch government should consider banning designated smoking rooms too.